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tympanoplasty."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":3,"max":6,"unit":"weeks","qualifier":"Light activity earlier; strenuous exercise, straining and heavy lifting avoided for 3-6 weeks."},"final_result_months":{"min":2,"max":3,"unit":"months","qualifier":"Graft healing and stabilised hearing usually assessed about 2-3 months after surgery, sometimes longer."},"fly_home_after_days":{"min":14,"max":28,"unit":"days","qualifier":"Fly after the postoperative ENT check shows graft healing, typically 2-4 weeks; cabin pressure changes can displace the graft earlier."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":7,"max":14,"unit":"days","qualifier":"First postoperative visit; ear packing or dressing and any non-absorbable sutures addressed."}},{"purpose":"assessment","requirement":"routine","after":{"min":14,"max":28,"unit":"days","qualifier":"Otoscopic check of graft healing; clearance for air travel."}},{"purpose":"result_review","requirement":"routine","after":{"min":60,"max":120,"unit":"days","qualifier":"Repeat audiogram and graft assessment."}}],"indications":["Chronic tympanic membrane perforation, with or without recurrent ear discharge","Conductive hearing loss due to perforation or tympanic membrane defect","Recurrent middle ear infection related to perforation","Tympanic membrane retraction or atelectasis in selected cases","Dry perforation with a healthy middle ear after infection control","Traumatic tympanic membrane perforation that fails to heal spontaneously","Iatrogenic perforation persisting after ventilation tube extrusion or removal"],"main_risks":["Graft failure or persistent/recurrent perforation","Sensorineural hearing loss (rare, including deafness)","Taste disturbance from chorda tympani nerve injury, usually temporary","Tinnitus or dizziness","Infection or ear discharge","Ear canal narrowing or lateralization of graft","Facial nerve injury (rare)","Anesthesia-related risks","Bleeding or hematoma","Need for revision surgery"],"pain":"Usually mild to moderate ear and graft-harvest-site discomfort for a few days, controlled with oral analgesics; fullness and muffled hearing from packing are common.","preparation":["Otoscopic examination and audiometry","Clear ear infection; ensure a dry ear","Preoperative anesthesia assessment and fasting as instructed","Review of medical history and current medications with surgical team","Keep water out of the ear","Imaging (e.g., CT) only in selected cases"],"recovery_timeline":[{"phase":"First days","description":"Rest at home; ear packing and dressing in place, mild pain, muffled hearing and possible slight drainage.","restrictions":["Keep ear dry","Avoid nose blowing","Sneeze with mouth open","Avoid straining"]},{"phase":"Weeks 1-2","description":"First postoperative review; packing or dressing partly removed at clinic review; most return to light work.","restrictions":["Keep ear dry","Avoid air travel until cleared","Avoid heavy lifting"]},{"phase":"Weeks 3-6","description":"Gradual graft healing and packing dissolution or removal; return to normal activity.","restrictions":["Avoid strenuous exercise until cleared","Avoid swimming until cleared"]},{"phase":"Months 2-3","description":"Graft healing confirmed and hearing retested.","restrictions":[]}],"rehabilitation_days":{"min":7,"max":21,"unit":"days","qualifier":"Ordinary functional recovery for daily activities after uncomplicated primary tympanoplasty; no formal rehabilitation program is usually needed."},"result_longevity":"If the graft heals, the closed eardrum is usually permanent, and hearing gains are generally maintained long term. Late re-perforation, retraction or cholesteatoma is uncommon, but it can occur, so periodic ear checks are advised.","revision_rate_pct":{"min":5,"max":12,"unit":"percent","qualifier":"Patients needing repeat surgery, mainly for residual or recurrent perforation, within about 1–2 years; graft failure is 3–15%."},"scars":"Transcanal approach leaves no visible scar; postauricular or endaural approaches leave a small, usually well-hidden incision behind or at the ear.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operation for uncomplicated primary tympanoplasty; staged surgery is reserved for complex cases."},"stages":[{"code":"tympanoplasty_surgery","label":"Tympanoplasty with graft reconstruction of the tympanic membrane","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed on day of surgery."}}],"qualifier":"Follow-up checks are routine care, not additional treatment stages."},"success":{"metric":"Graft take rate (intact tympanic membrane)","value":90,"unit":"percent","horizon":"12 months","evidence_status":"limited","population":"Adults and children after primary tympanoplasty or myringoplasty; reported graft take about 82–97%."},"techniques":[{"name":"Underlay (medial) graft tympanoplasty with temporalis fascia or cartilage","suits_whom":"Most common approach for small to large perforations with adequate remnant for support.","recovery":"Similar to standard recovery; packing in the middle ear and healing over weeks."},{"name":"Overlay (lateral) graft tympanoplasty","suits_whom":"Selected anterior or total perforations where the remnant is inadequate.","recovery":"Often somewhat longer epithelial healing."},{"name":"Endoscopic transcanal tympanoplasty","suits_whom":"Selected small to medium perforations with accessible margins.","recovery":"Avoids external incision and may allow quicker comfort."}],"treatment_conditions":["day_case","outpatient"],"treatment_duration_hours":{"min":1,"max":3,"unit":"hours","qualifier":"Operative time for uncomplicated primary tympanoplasty without mastoidectomy."},"initial_assessment_documents":["Recent pure-tone audiogram","Temporal bone CT scan report","Otoscopy or otoendoscopy photos of the eardrum","ENT clinic notes on ear discharge history","Prior ear surgery operative reports"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage surgery; stay about 2-4 weeks until the postoperative ENT check clears air travel. Later reviews are done locally."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Confirm the surgeon is trained and experienced in the exact procedure you are considering, not just in surgery generally","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Verify that the surgeon is trained and experienced in performing the procedure you are considering.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C2","text":"Ask for certification information and the name of the body that certified the surgical setting","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Ask for certification information and the name of the certifying body when assessing a surgical setting.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C3","text":"Check that the surgeon who consults with you is the same person who will carry out the procedure","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Check that the surgeon you consult with, will be the same person carrying out the procedure.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C4","text":"Ask whether a doctor is always present in the clinic and whether a high dependency or intensive care unit exists","scope":"treatment_abroad","source":{"url":"https://www.bapras.org.uk/public/patient-information/cosmetic-surgery/cosmetic-surgery-abroad","host":"bapras.org.uk","quote":"Is there always a doctor in the clinic and is there a high dependency or intensive care unit?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C5","text":"Ask whether the surgeon and the facility use a surgical safety checklist, which can reduce complications","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Do the surgeon and his/her facility use a safety checklist?","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F2","text":"Forceful persuasion or cheap, time-limited offers pushing you into a quick decision","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"A price that sounds too good to be true probably is","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/news/articles/will-economic-uncertainty-drive-more-patients-overseas-for-plastic-surgery-what-to-consider-and-how-to-stretch-your-dollar-back-home","host":"plasticsurgery.org","quote":"If the price sounds too good to be true, it probably is.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-13","next_check_at":"2027-02-11"},"take_home":{"status":"ok","items":[{"id":"T1","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T2","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge 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position the tissue under your entire eardrum or just the hole.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"overlay-graft-tympanoplasty","name":"Overlay (lateral) graft tympanoplasty","how_it_works":{"text":"Graft is placed on top of the remaining eardrum ring","source":{"url":"https://www.entnet.org/resource/cpt-for-ent-tympanoplasty-2/","host":"entnet.org","quote":"The surgeon chooses an appropriate technique for placement of the graft under (underlay or medial graft technique) or on top of the remaining annulus (overlay or lateral graft technique).","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"endoscopic-transcanal","name":"Endoscopic transcanal 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